Why are so many young men depressed?

by ROBERT CHESSHYRE, Evening Standard

One midsummer morning, Charles Acheson-Gray turned up on his parents' doorstep in a pretty village in the Surrey stockbroker belt. He was 28, a solicitor with a major City of London commercial firm, and he should have been at work. But the night before he had cut his wrists - "more a cri de coeur than a suicide attempt'' his father said later - and had come in his unhappiness to the parental home for support and help.

It was the first act in what was to prove a seven-month nightmare. Having tended to his wounds with butterfly dressings, his parents - Patrick, a retired senior manager in industry, and Liz, an ex-nurse - took Charles to their GP. The doctor prescribed anti-depressants and signed him off work. As far as his employers were concerned, Charles was suffering from "a viral infection with flu-like symptoms.''

His parents knew he had been working ridiculous hours. The night before he cut his wrists he had worked through until 4am, and until midnight the night before that. They also knew he was deeply upset by the break-up of his six-year relationship with his girlfriend. But the rest of Charles's life was going well.

He had just returned from a fishing holiday in Venezuela, and fishing was his passion. He had earlier been best man at a wedding, and he earned a very decent salary.

He was extremely able and had gone from public school to Cambridge, where he won a half-blue for real tennis and played college rugby. His parents were aware that he sometimes seemed "not entirely comfortable in his own skin, and "appeared slightly bewildered by the w orld", but he had never given them cause to worry about his mental stability.

He sided with underdogs, people less fortunate than himself (he supported an orphan in Latin America), and was unusually conscientious, hence the crazy hours he worked. He was "the opposite of happy-go-lucky types who sit back with their feet on the desk", said his father.

When Charles returned to work, his depression became more evident. Clinical depression was diagnosed and day care suggested.

How ever, one day at a day treatment centre was all he could handle. He found the regime, which was pitched at an accessible level for most patients, insulting to his intelligence. He was also horrified by the depths to which some fellow patients had descended.

It seems likely, too, that for the first time he understood that what was wrong with him might not simply be a passing mood, but a persistent illness. He had fallen into a black hole, and it was likely to prove a long haul out.

That night he made a serious suicide attempt. He suffered from "powerful and mixed-up emotions", and began, hurtfully, to turn against his parents. A GP called to their house said later that she had never seen anyone so determined to kill himself.

There followed five weeks' inpatient treatment at a private clinic. Charles was on suicide watch for 48 hours, never alone, and anything he might have used to harm himself was removed.

On discharge, he was best man at another wedding. "He gave a witty speech and all the girls said that he was lovely," said the bride. Encouraged by his psychiatrist, he returned to work, which "baffled" his parents. They did not believe he was ready. "If he had had three months off to regain his equilibrium, the outcome might have been different," they said.

Charles was prescribed a series of drugs, none of which seemed to help, and he was sleeping badly - a classic sign of clinical depression. There followed a further serious suicide attempt and another stay at the clinic. Haunted by the stigma he believed depression carries, Charles refused to let anyone except his immediate family know what was wrong. In February this year, he went to a beauty spot near his parents' home and hanged himself.